POZ232_December

Pain in the...
Everyone experiences pain at some point, but an estimated one in five adults in the United States have chronic pain, which is defined as pain that persists for three months or more. POZ wants to know about any pain in your life.
1) How long have you been living with HIV?

Less than one year1–5 years5–10 years10–15 years15–20 years20 years or moreI’m not HIV positive.
2) In the past three months, how often did you experience pain?

NeverSome daysMost daysEvery day
3) In the past three months, how often did pain limit your life or work activities?

NeverSome daysMost daysEvery day
4) In the past three months, what type of pain did you have? (Check all that apply.)

Abdominal painArthritisBack painCarpal tunnel syndromeFibromyalgiaHeadache/migraineMuscle painNeck painNumbness in hands/feetNone of the above
5) In the past three months, did you use any of these pain relief products? (Check all that apply.)

Over-the-counter pain reliever (e.g., aspirin, ibuprofen)AntidepressantsAnti-seizure medicationsMuscle relaxersOpioidsSteroidsTopical (cream, patch)None of the above
6) In the past three months, did you use any of the following for pain relief? (Check all that apply.)

AcupunctureBiofeedbackCannabisExerciseHerbal remediesMassagePhysical therapyRelaxation techniques
7) How much money do you spend every month on pain relief?

$0–50$50–$100$100–$250More than $250
8) Do you have chronic pain?

YesNo (Skip to question 13.)
9) How long have you had chronic pain?

Less than one year1–5 years5–10 years10–15 years15–20 years20 years or more
10) How would you describe your chronic pain?

MildModerateSevere
11) Does chronic pain affect your quality of life?

YesNo
12) Have you experienced any of the following conditions as a result of chronic pain? (Check all that apply.)

AnxietyDepressionFatigueInsomniaMood swingsNone of the above
13) What year were you born?
14) What is your gender?

MaleFemaleTransgenderOther
15) What is your sexual orientation?

StraightGay/LesbianBisexualOther
16) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
17) What is your current level of education

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
18) What is your annual household income?

Less than $15,000$15,000–$34,999$35,000–$49,999$50,000–$74,999$75,000–$99,999$100,000 or more
19) What is your zip code?
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Pain in the...